Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Child Development Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKE W ROSSHEIM M.D., M.P.H. (DIRECTOR)
(540) 899-4797
Entity
Organization
Contact information
Practice address
10708 BALLANTRAYE DRIVE, SUITE 204, FREDERICKSBURG, VA 22407-4701
(540) 891-3151
(540) 891-3152
Mailing address
608 JACKSON STREET, FREDERICKSBURG, VA 22401-5719
(540) 899-4797
(540) 899-4599
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
VA
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007600399
VIRGINIA PREMIER
VA
05
—
007600399
—
VA
01
—
27523
OPTIMA/SENTARA
VA
Enumeration date
07/05/2006
Last updated
06/13/2011
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